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ROSENKRANS v. WETZEL

January 19, 2001

JENNIFER LYNN ROSENKRANS AND MARK HUNSINGER, PLAINTIFFS,
V.
GEHRED WETZEL, D.O., KENNETH A. THOMPSON, TYLER MEMORIAL HOSPITAL PENN STATE GEISINGER MEDICAL CENTER, VIA LIFE FLIGHT, PENN STATE GEISINGER HEALTH PLAN, PENN STATE GEISINGER MEDICAL GROUP, DEFENDANTS.



The opinion of the court was delivered by: Conaboy, District Judge.

MEMORANDUM AND ORDER

I

On July 25, 2000, the Plaintiffs filed a Complaint in this case seeking damages for the death of Hannah June Hunsinger. The Complainants named Penn State Geisinger Health Plan as one of the Defendants, and based their claims for damages on the alleged tortious and negligent conduct of the Defendants, which resulted in the death of Hannah June Hunsinger.

On August 29, 2000 Defendant, Penn State Geisinger Health Plan, removed this action to this Federal Court. In doing so, the Defendant argued that "because Plaintiffs' claims for a delay and a denial of benefits are specifically provided in § 502(a)(1)(B) of the Employee Retirement Income Security Act (ERISA), 29 U.S.C. § 1132(a)(1)(B), this action is removable to this court pursuant to the complete preemption exception to the wellpleaded complaint rule." In addition, Defendant alleged that "in Count V(B) of their Complaint, Plaintiffs purport to be bringing their claim against Defendant, Penn State Geisinger Health Plan, not for a denial of care, but rather on the basis of the delivery of poor quality of health care." (See Doc. # 1, Exhibit "A" Paragraph 76).

On November 2, 2000, Plaintiffs filed a motion to remand this case to the State Court arguing that this is a "medical malpractice claim" and that there is no federal issue involved which would require removal to the federal court system. In the motion to remand, Plaintiffs allege that they "did not seek to make any claims in this case on the basis of denial of care, under ERISA, or a breach of fiduciary duty by the health plan." The Plaintiffs further argue that in Paragraph 76 of the Complaint, they allege "the plaintiffs bring their claim against defendant, GHP, not for a denial of care, but rather on the basis of delivery of poor quality health care which was caused by the corporate negligence of this HMO company." (Doc. # 21)

On November 15, 2000 the Defendant filed its Answer in opposition to the Plaintiffs' Motion to Remand. In the Answer to the Motion to Remand, Defendant argued that contrary to the Plaintiffs' assertions, the Plaintiffs do, in fact, assert a claim against the Defendant, Penn State Geisinger Health Plan, arising under the laws of the United States, § 502(a)(1)(B) of ERISA, 29 U.S.C. § 1132(a)(1)(B), . . . and further, that "Section 514 of ERISA, 29 U.S.C. § 1144(a) preempts all of Plaintiffs' State Law claims against the HMO Defendant". The Defendant further asserted that in "light of the holding of the Supreme Court of the United States in Pegram, supra., Plaintiffs claims against Defendant, Penn State Geisinger Health Plan, may be preempted by the Health Maintenance Organization Act, 42 U.S.C. § 300(e) et seq. (1973)." (Doc. # 23)

We find that the Defendant's concept and argument is factually flawed and thus not legally correct, therefore, we will remand this action to the Court of Common Pleas of Lackawanna County.

II

The concepts of exemption and removal exist to allow actions to be transferred to the federal court system when those actions are obviously based on some federal law or federal legislation. But the Federal Courts have no jurisdiction in matters where State authority has been traditionally recognized and such cases must be remanded to the State Courts unless it is clear that the parties are acting according to specific federal laws or under federal authority. Indeed, New York State Conference of Blue Cross and Blue Shield Plans v. Travelers Ins. Co., 514 U.S. 645, 115 S.Ct. 1671, 131 L.Ed.2d 695 (1995), instructs that there is "no ERISA preemption without clear manifestation of congressional purpose."

The Defendant proceeded in this removal action under the supposed authority of Dukes v. U.S. Healthcare, Inc., 57 F.3d 350 (3d Cir. 1995) (hereinafter Dukes) and In re U.S. Healthcare, Inc., 193 F.3d 151 (3d Cir. 1999) (hereinafter Bauman) and more specifically, the recent case of Pegram v. Herdrich, 530 U.S. 211, 120 S.Ct. 2143, 147 L.Ed.2d 164 (2000).

While acknowledging that the Complaint is generally a tort claim, alleging medical malpractice — the Defendant argues that the claim set forth in Section V(B), is one that requires removal because of allegations of the failure of an HMO (Defendant) to live up to terms of a plan covered by ERISA, in that the Defendant HMO allegedly denied the Plaintiff eligibility for benefits.

The Defendant goes on to argue that this type of claim falls squarely within the terms of ERISA and that the Plaintiffs are preempted from bringing such a claim in a State Court.

We find that the Defendant's argument, and particularly, the reliance on Pegram, is more hope than practical reality in that it:

1. wrongly classifies the Plaintiffs' Complaint which is a true medical malpractice action and not a fiduciary or ...


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